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肾功能的生化标志物

Biochemical Markers of Renal Function.

作者信息

Krstic Danijela, Tomic Nenad, Radosavljevic Branimir, Avramovic Natasa, Dragutinovic Vesna, Skodric Sanja Radojevic, Colovic Mirjana

机构信息

Institute of Medical Chemistry, School of Medicine, University of Belgrade, Višegradska 26, 11 000, Belgrade, Serbia.

出版信息

Curr Med Chem. 2016;23(19):2018-40. doi: 10.2174/0929867323666160115130241.

Abstract

Kidney damage can be induced by ischemia, autoimmune diseases, hypertension, allograft rejection, metabolic or genetic disorders, infections or toxins. The influence of these factors could result in acute kidney injury (AKI) defined as an unexpected decrease in urine output or renal function, or encourage the development of chronic kidney disease (CKD). Biomarkers of renal function, measured in urine and serum, are in increasing use in order to estimate the severity and nature of kidney injury, and consequently apply appropriate therapy and improve patient management. The determined values of biomarkers can suggest the potential risk of kidney disease and the type of renal injury, predict the disease progression, as well as be helpful for assessing the response to an applied therapy. Although novel biomarkers are in practical use, serum creatinine, the indicator of glomerular filtration rate is still the most frequently used biomarker of renal function despite its known limitations. In recent decades, numerous studies resulted in discovering urinary and serum proteins that can serve as biomarkers for early and accurate detection of AKI and its development, as well as the identification of CKD. This review gives an overview of the most important renal biomarkers investigated in kidney diseases, classified in following types: functional biomarkers, up-regulated proteins, enzymes, and cycle arrest biomarkers. It describes their properties, physiological roles, and discusses the utility of these molecules in different clinical settings.

摘要

肾脏损伤可由缺血、自身免疫性疾病、高血压、同种异体移植排斥反应、代谢或遗传紊乱、感染或毒素引起。这些因素的影响可能导致急性肾损伤(AKI),其定义为尿量或肾功能意外下降,或促使慢性肾脏病(CKD)的发展。在尿液和血清中检测的肾功能生物标志物正越来越多地被用于评估肾损伤的严重程度和性质,从而应用适当的治疗方法并改善患者管理。生物标志物的测定值可以提示肾病的潜在风险和肾损伤的类型,预测疾病进展,也有助于评估对所应用治疗的反应。尽管新型生物标志物已在实际应用中,但肾小球滤过率指标血清肌酐尽管存在已知局限性,仍是最常用的肾功能生物标志物。近几十年来,大量研究发现了可作为AKI早期准确检测及其发展以及CKD识别的生物标志物的尿液和血清蛋白。本综述概述了在肾脏疾病中研究的最重要的肾脏生物标志物,分为以下几类:功能生物标志物、上调蛋白、酶和细胞周期阻滞生物标志物。它描述了它们的特性、生理作用,并讨论了这些分子在不同临床环境中的实用性。

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